Annesley-Williams DJ

Brennan RP

Gholkar A

Goddard AJ

The purpose of the study was to assess the cure rate in patients with indirect carotico-cavernous fistula (CCF) treated by transvenous embolisation via the inferior petrosal sinus (IPS) pathway or the superior ophthalmic vein (SOV). Twelve fistulae in 11 patients were treated by transvenous embolisation, eight patients via the IFS and four fistulae in three patients via the SOV. Angiographic cure was defined as complete obliteration of the fistula and clinical cure as total resolution of signs and symptoms. Complete cure was achieved in eight patients with nine fistulae embolised transvenously. Five fistulae were approached via the IFS and four via the SOV. Our preferred method for treatment of indirect CCF is the transvenous route. The IFS approach is technically easier and has fewer potential risks than the SOV approach. However, if the IFS is not patent the SOV can provide good alternative access to the cavernous sinus

Endovascular approach to treatment of indirect carotico-cavernous fistulae

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